Rlchard Pettlnger

General Adaptation Syndrome

General Adaptation Syndrome (GAS) offers a healthcare perspective on the identification and management of stress. It was originally defined as ‘‘the sick syndrome’’ whereby those with a variety of diseases had similar signs and symptoms including weight loss, appetite loss, decreased muscular strength, and no ambition. A variety of dissimilar situations, such as arousal, grief, pain, fear, unexpected success or loss of blood, are all capable of producing similar physiological responses. Although people may face quite different stressors, in some respects their bodies respond in predictable fashions.

Three stages are identified: alarm, resistance, and exhaustion.

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» Alarm is predominantly initiated and controlled by the sympathetic nervous system and affects organs such as the brain and the heart, and skeletal muscles. These initial effects are prolonged by the simultaneous release of adrenaline and noradrenaline. This is the equivalent of the ‘‘fight or flight’’ factor referred to in Chapter 3. The effects of this stage are ideally short-term responses operating to enable people to cope with, or adapt to, particular stressors that are present at the time. If the situation can be successfully controlled then organ functions return to their normal state. If the stressors remain at, or above, these levels then individuals go into the resistance or adaptation stage.

» Initial response at the resistance stage is to produce hormones that generate increased levels of blood sugar to provide the body with the energy necessary to cope with the effects of the stressors. The amount of adaptation energy is a function of the physical and psycho- logical condition of the individual affected. Every stressor causes the equivalent of wear and tear, both physical and psychological. At this stage, individuals exhibit high levels of activity; and they get many things right and many things wrong. If the individual cannot adapt then they proceed to the stage of exhaustion.

» In exhaustion, the signs of the alarm stage reappear but at a much greater stress level. This leads to stress-related illnesses, when clin- ical intervention is required to restore the patient’s physical and psychological processes. It is essential to be able to identify the major stressors associated with the illness, and then these can be removed or treated.

The process is shown in Figure 8.1.

This clearly indicates the relationship between effective stress management and the medical aspects of stress. At the point at which nursing and medical intervention is required, so is effective stress management on the part of those in organizations. Each of the systems indicated, and the human response, is clearly observable by those in responsible managerial positions.

Source: Selye, H. (1976) The Stress of Life. McGraw Hill.

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